Government Code § 549.0005

Sec. 549.0005. PRIOR APPROVAL OF AND PHARMACY PROVIDER ACCESS TO CERTAIN COMMUNICATIONS WITH CERTAIN RECIPIENTS AND ENROLLEES. (a) This section applies to: (1) the vendor drug program for Medicaid and the child health plan program; (2) the kidney health care program; (3) the children with special health care needs program; and (4) any other state program the commission administers that provides prescription drug benefits. (b) A managed care organization, including a health maintenance organization, or a pharmacy benefit manager, that administers claims for prescription drug benefits under a program to which this section applies shall, at least 10 days before the date the organization or pharmacy benefit manager intends to deliver a communication to recipients or enrollees collectively under a program: (1) submit a copy of the communication to the commission for approval; and (2) if applicable, allow the pharmacy providers of the recipients or enrollees who are to receive the communication access to the communication. Added by Acts 2023, 88th Leg., R.S., Ch. 769 (H.B. 4611), Sec. 1.01, eff. April 1, 2025.